Who's cooking? Trends in US home food preparation by gender, education, and race/ethnicity from 2003 to 2016

Balancing nutrition and budgets: Socio-ecological impacts on nutritional environments of families with low incomes

BACKGROUND

Research on childhood nutritional environments, which are predictive of a variety of child and family health and wellbeing outcomes, has primarily focused on parenting behaviors and the home food environment. However, broader social and community factors play an important role in shaping nutritional environments during early childhood. Food security is a key example that is closely linked to nutrition-related health disparities, which can arise from constrained financial resources and material deprivations. Understanding parent and caregiver lived experiences related to social and community components of family nutritional environments in the context of economic constraints could help to support multi-level nutritional practices that are optimal for healthy child development.

METHOD

Semi-structured in-depth interviews were conducted using a narrative approach with parents (n = 21) of pre-school aged children living near or below the poverty line. Participants were recruited from social and community service sites pertinent to maternal and child health in Philadelphia where health disparities are highly concentrated. Analysis was conducted using MAX QDA analytic software following a systematic approach for thematic analysis in narrative research.

RESULTS

Three themes describe the feeding and eating environments in the home and community context: 1) Food Procurement and Meal Planning; 2) Family Togetherness; 3) Creativity, Variety, and Flexibility. Creative decision making and food procurement strategies responsive to child preferences were balanced by shopping to save and visiting multiple stores for the best foods and savings. Logistical (e.g., transportation, childcare) and emotional supports facilitated food shopping habits and routines, while lack of trusted childcare, reliable transportation, and social support barriers challenged feeding and eating decisions.

CONCLUSION

Strategies for improving cost and time-efficiencies could help support health-promoting nutritional environments of families with food insecurity. Building social and community capacity and facilitating connections to practical supports that include trustworthy childcare and peer support may be particularly important for this population.

What do you want to eat? Cuisine and nutrition intervention preferences among people using a large food pantry in Texas

Objective

Nutrition interventions delivered through food pantries could reduce health disparities for people experiencing food insecurity. We identified clients' preferences for cuisines, nutrition interventions, and outcomes and whether preferences differ for subpopulations.

Methods

Cross-sectional study at a large pantry in Dallas, Texas (N = 200). Survey collected from February-May 2023 on demographics, cuisine preferences, nutrition intervention preferences, and outcomes clients hope to achieve when changing lifestyle (weight loss, feeling comfortable in clothes, feeling good about diet, wellbeing). A subsample (N = 130) had height and weight measured. We tested whether food security and BMI (categorical) were associated with intervention or outcome preferences using IBM SPSS Statistics (Version 29) to conduct analysis of variance.

Results

Top-rated cuisines were Mexican, Chinese, Italian. Participants reported a desire for interventions implemented through the pantry reflected by high Nutrition Intervention Index scores. The highest rated intervention was bringing more healthy food into the pantry and lowest rated was restricting unhealthy donations.Overall wellbeing was the most important outcome and weight loss the least important.Neither food security nor BMI were associated with desire for interventions. All outcomes were rated in a similar pattern, though people with obesity and overweight rated weight loss as more important than people with normal weight.

Conclusions

Most participants demonstrated a strong desire for healthier, ethnically diverse options, and nutrition interventions delivered through the pantry. Our findings explore cuisines and outcomes preferred by people that use food pantries which can guide researchers, clinicians, and non-profit organizations in planning and promotion of nutrition programs for pantry clients.

[Food gatekeepers: a reflection on gender roles in domestic environments]

Introduction

Diet quality in U.S. adults eating in senior and community centers: NHANES 2009-2018

BACKGROUND

With advancing age, the worsening of cognitive and physical disabilities may lead older adults to seek help in their daily living activities. Community/senior centers support older adults during aging, offering a wide variety of services, including meal programs. Using data from the National Health and Nutrition Examination Surveys (2009-2018), we aimed to examine whether community/senior center meal programs were associated with an improved nutritional exposure in U.S. adults aged 60 years or older.

METHODS

Nutrient exposure and nutrient-based dietary indexes, including the Diet Quality Score (DQS) and the Food Nutrient Index (FNI) were compared between those eating meals at community/senior centers and the general population. Nutrient intakes were contrasted to the daily nutritional goals from the Dietary Guidelines for Americans.

RESULTS

This study included 6261 participants aged ≥60 years, thereof n = 421 reporting community/senior center meals. The latter were predominantly female and almost 45% were widowed or divorced. Eating at community/senior centers did not result in a better diet quality in crude analyses. After adjustment for potential sociodemographic confounders as well as alcohol, smoking and energy intake, however, sex-specific differences emerged, revealing significantly higher FNI scores in males eating at community/senior centers (adjusted FNI predictions: 61.71 [CI:58.55-64.88] vs 57.64 [CI:56.86-58.41] points).

CONCLUSIONS

Eating at community/senior centers was associated with an improved nutrient exposure in older men, whereas no better diet quality was found in women. Community/senior centers may play a pivotal role when it comes to the diet quality of a particularly vulnerable group of the population.

Patient Perception of Preoperative Nutrition and Recovery After Orthopaedic Surgery

BACKGROUND

Mounting evidence supports the use of nutritional supplementation to improve patient outcomes. The intent of this study was to utilize an anonymous questionnaire to determine patients' baseline knowledge, attitude, and belief regarding nutrition before total hip (THA) or total knee arthroplasty (TKA).

METHODS

After receiving Institutional Review Board approval, an anonymous questionnaire was administered to 300 patients, comprising 184 women (61.3%) and 116 men (38.6%), averaging 67 years (range, 39 to 89). There were 238 TKAs (79.3%), 12 revision TKAs (4%), 44 THAs (14.6%), and 6 revision THAs (2%).

RESULTS

Almost all (99.6%) subjects recognized the importance of preoperative nutrition. Most (83.0%) claimed that they knew what to eat preoperatively to optimize their surgical outcomes and expressed high levels of self-reported confidence (98.6%). Women were more likely to report having knowledge of preoperative nutrition (P = .05), and advanced education levels were linked to higher confidence (P = .002). Only 169 (56.3%) subjects reported knowing what supplements to take. When asked, 84% of subjects stated that they would purchase a nutrition program if recommended by their surgeon. Most studies show that an improved diet and appropriate supplementation can optimize nutritional status and potentially improve surgical outcomes.

CONCLUSIONS

The results of this study confirm that most patients do not know how to achieve optimal nutrition. Therefore, we believe there is a need for patient education on preoperative nutrition and its benefits.

Evolution of dietary patterns in Flanders: an ecological trend study on best-selling cookbook recipes (2008-2018) and their correlation with household purchases

BACKGROUND

With rising obesity rates in Western societies, analyzing changes in dietary patterns is paramount. While nutritional surveys have been informative, traditional cookbooks have historically shed light on national cuisines and its changes. Despite the growing popularity of online platforms for food information, cookbooks might still reflect prevalent dietary trends and the diets people follow. This study examined (1) the changes in nutritional content and food group usage in the best-selling cookbooks from 2008 to 2018, and (2) the correlation between the food groups in these cookbooks and dietary patterns (inferred from household purchases) over the same timeframe.

METHODS

An exploratory ecological study was conducted on 20 main course recipes of each of the five best-selling cookbooks in Flanders annually between 2008 and 2018. Trends in macronutrients and food group usage in these recipes were analyzed using generalized linear models. Additionally, these trends were compared to household purchase data in Flanders using correlation matrices.

RESULTS

Our results reveal a rising trend towards the use of plant-based ingredients and meat alternatives in cookbooks over the period 2008-2018. There was an increase in the usage of vegetables, nuts & seeds, and cheese. Conversely, there was a decline in the usage of meat, sugar & sweeteners, alcohol, and dairy (all p-values < 0.05). In terms of macronutrient content, there was an upswing in carbohydrate, fibre, and sugar levels, while the total fat content showed a decrease (all p-values < 0.05). The levels of protein and saturated fat remained consistent over time. Notably, shifts in plant-based and animal-based food group preferences in popular cookbook recipes align with the trends seen in actual household purchases of these food groups (all p-values < 0.05).

CONCLUSION

These findings indicate that cookbook content evolves over time, potentially reflecting shifts in population dietary patterns. Future research is needed to determine (Buisman ME, Jonkman J. Dietary trends from 1950 to 2010: a Dutch cookbook analysis. J Nutr Sci [Internet]. 2019 ed [cited 2022 Apr 19];8. https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/dietary-trends-from-1950-to-2010-a-dutch-cookbook-analysis/AB281ADE0F09FF8F518B8AC4A2A5BEA8#supplementary-materials ) any causative link between cookbooks and dietary habits, and (Ashwell M, Barlow S, Gibson S, Harris C. National Diet and Nutrition Surveys: the British experience. Public Health Nutr. 2006;9(4):523-30.) the potential for cookbooks to aid in health promotion.

An online qualitative study exploring wants and needs for a cooking programme during pregnancy in the UK and Ireland

BACKGROUND

Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI).

METHODS

Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed.

RESULTS

Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy-specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content.

CONCLUSIONS

Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in-person sessions using a hybrid structure to enable the development of a support network.

Engagement in a pilot produce prescription program in rural and urban counties in the Southeast United States

Introduction

In the United States, over one in every ten households experiences food insecurity. Food insecurity is associated with often co-occurring adverse health consequences, including risk for obesity, type 2 diabetes, and hypertension. Within the "Food is Medicine" intervention space, Produce Prescription Programs (PRx) seek to alleviate food insecurity and improve diet and health outcomes by leveraging access to produce through healthcare organizations. Though these programs are burgeoning across the United States, research surrounding their implementation and outreach is limited.

Methods

This study evaluates the implementation, reach, engagement, and retention of a PRx program piloted in two regions of Georgia (US) from 2020 to 2022. The study included 170 people living with one or more cardiometabolic conditions recruited from clinical sites in metropolitan and rural areas. The program provided pre-packaged produce boxes and nutrition education over six months. We examine participants' baseline demographics, food security status, dietary patterns, and loss to follow-up across contexts (metropolitan and rural). We employ regression analyses and model comparison approaches to identify the strongest predictors of loss to follow-up during the pilot period.

Results

In the pilot period of this program, 170 participants enrolled across rural and metropolitan sites. Of these, 100 individuals (59%) remained engaged for the six-month program. While many individuals met the target criteria of living with or at-risk of food insecurity, not all lived with low or very low food security. Metropolitan participants, males, and those with children in the household had significantly higher odds of loss to follow-up compared to rural participants, females, and those without children in the household. No other significant demographic or household differences were observed.

Discussion

This study demonstrates the potential of PRx programs to enhance food and nutrition security and cardiometabolic health in metropolitan and rural clinical settings. Future research should focus on addressing barriers to engagement and expanding the reach, impact, and sustainability of PRx programs across diverse contexts.

Associations between cooking skills, cooking with processed foods, and health: a cross-sectional study

To improve health outcomes, home cooking has been suggested as a solution to reduce intakes of processed foods. However, little is known about how cooking skills or cooking with processed foods influence health. This cross-sectional study examined associations between diet and health outcomes with cooking skills and cooking with processed foods. The dataset included a nationally representative sample of 18 460 adults from Canadian Community Health Survey (CCHS) annual component rapid response modules on food skills. In the CCHS rapid response modules, diet and health outcomes (fruit and vegetable intake, general health, mental health, and obesity) and data related to cooking skills and cooking with processed foods were collected through self-report. Separate logistic regression models were fitted for each outcome, controlling for age, income, and education, and stratified by sex. Adults with poor cooking skills were less likely to have adequate fruit and vegetable intake (≥5 servings per day) (p < 0.001), very good general health (p < 0.001) or mental health (p < 0.001), and obesity (p = 0.02) compared to advanced cooking skills. Adults who cooked with highly processed foods were less likely to have adequate fruit and vegetable intake (p < 0.001), very good general health (p = 0.002) or mental health (p < 0.001), but more likely to have obesity (p = 0.03) compared to cooking with minimally processed foods. Cooking skills alone appear insufficient to protect against obesity. Results suggest that not only are cooking skills important, but the quality of ingredients also matter. Limiting the use of processed foods in addition to improving cooking skills are potential intervention targets to promote better health and diet outcomes.

Food is medicine intervention shows promise for engaging patients attending a safety-net hospital in the Southeast United States

Public health organizations, including the Academy of Nutrition and Dietetics and the American Hospital Association, recognize the importance of achieving food and nutrition security to improve health outcomes, reduce healthcare costs, and advance health equity. In response, federal, state, and private agencies are increasingly seeking to fund healthcare-based interventions to address food insecurity among patients. Simultaneously, nutrition-based interventions targeting chronic diseases have grown across the United States as part of the broader "Food is Medicine" movement. Few studies have examined the successes, challenges, and limitations of such efforts. As Food is Medicine programs continue to expand, identifying common approaches, metrics, and outcomes will be imperative for ensuring program success, replicability, and sustainability. Beginning in 2020, the Food as Medicine (FAM) program, a multipronged, collaborative intervention at Grady Health System has sought to combat food insecurity and improve patient health by leveraging community resources, expertise, and existing partnerships. Using this program as a case study, we (1) outline the collaborative development of the FAM program; (2) describe and characterize patient engagement in the initial 2 years; and (3) summarize strengths and lessons learned for future hospital-based food and nutrition programming. As this case study illustrates, the Food as Medicine program provides a novel model for building health equity through food within healthcare organizations.

Associations between cooking self-efficacy, attitude, and behaviors among people living alone: A cross-sectional survey analysis

Cooking-related literacy and attitudes may play important roles in preventing and reducing diet-related chronic diseases and nutrition disparities. People living alone are an under-researched but growing population who face above average food insecurity rates. This study's objectives were to 1) test how cooking self-efficacy and attitude are stratified demographically among a sample of people living alone, focusing on variations across gender, age, and food security, and 2) examine how cooking self-efficacy and attitude are associated with two indicators of cooking behavior - cooking frequency and convenience orientation. We draw from a cross-sectional survey analysis of 493 adults living alone in Illinois, USA with validated measures for cooking self-efficacy, attitude, frequency, convenience orientation, and demographic characteristics. Hierarchical linear regression models were used to examine demographic factors explaining variation in self-efficacy and attitude, with attention to interactions between gender, food insecurity, and age. Poisson and OLS linear regression models were used to examine associations between self-efficacy and attitude and cooking frequency and convenience orientation. We find cooking-related self-efficacy and attitude showed strong but distinct associations with cooking frequency and convenience orientation. Overall, food insecure groups had lower self-efficacy than those who were food secure; however, food insecure women had higher self-efficacy than men in similar positions, apart from older-adult women who held particularly low efficacy. Cooking attitudes varied in small ways, notably with food insecure younger and older women possessing more negative cooking attitudes than middle-aged women. This research highlights the importance of understanding the cooking-related orientations of single-living people, while demonstrating that this group's ability to prevent and manage food insecurity is not uniform. These results can inform targeted interventions around food and nutrition insecurity, cooking attitudes, and self-efficacy among single-living populations.

The level of food literacy and its association with food intake and obesity status among Seoul citizens: results from Seoul Food Survey 2021

BACKGROUND/OBJECTIVES

Food literacy (FL) is a crucial skill for selecting sustainable and healthy food options, necessitating the identification of vulnerable groups in the community using valid measurement tools. Identifying weak domains in FL is essential for enhancing the overall FL. This study examined the FL levels of Seoul citizens based on their sociodemographic characteristics and assessed the relationship between FL, food intake, and weight status.

SUBJECTS/METHODS

This study utilized the data from the Seoul Food Survey, a cross-sectional study employing representative samples of Seoul citizens. Data collection occurred from September to October 2021, with 4,039 citizens aged 18 yrs and above participating in face-to-face surveys. Thirty-three FL items were assessed, comprising 14 items in the nutrition and safety (NS) domain, eight items in the cultural and relational (CR) domain, and 11 items in the socio-ecological (SE) domain. In addition, data on food intake sufficiency and obesity status were collected. The descriptive statistics, t-tests, analysis of variance, and logistic regression analysis were used for analysis.

RESULTS

Men, students, young adults, older citizens, and people experiencing food insecurity had the lowest scores for all the FL domains. The highest quartile group of NS scores had a higher probability of consuming adequate servings of vegetables and fruits, with significant linear trends observed (P for trend < 0.05). In all three FL domains, the odds ratio for obesity was significantly lower in the groups with high FL scores (P < 0.05).

CONCLUSIONS

A close relationship was observed between low FL, obesity, and food intake, even after controlling for other covariates. Vulnerable groups with low FL were also identified. Therefore, it is essential to develop programs to improve FL and the health and well-being of these groups.

Designing a Digital Culinary Education Intervention for Parents With Low Income

OBJECTIVE

To examine cooking practices, online information-seeking habits, and intervention preferences among parents with low income to inform the development of a digital cooking intervention on the basis of the Healthy Cooking Index.

METHODS

This formative research study included a brief survey followed by in-depth interviews (from February to April, 2021) with parents of a child aged 6-11 years with low income (n = 20; 100% female, 70% African American or Hispanic White). Interview transcripts were analyzed using a semistructured hybrid coding approach.

RESULTS

Three main themes were identified to inform the development of the intervention: (1) current Healthy Cooking Index behaviors, (2) preferences for digital cooking intervention content, and (3) design and delivery preferences. A 7-step process was used to develop the intervention and integrate qualitative findings.

CONCLUSIONS AND IMPLICATIONS

Online culinary programs targeting parents with low income may consider short, mobile-friendly video formats and focus on easy-to-prepare recipes adaptable to family preferences.

Integrating coordination of food purchasing into activity space-based food environment research: Toward a household perspective

Despite the advances in person-based approaches to studying food environments, most studies using these approaches have relied on individual-centered activity space measures and largely ignored cohabiting household members who play crucial roles in shaping an individual's food access, food behaviors, and diet. This can be problematic for completely capturing food environments relevant to an individual and add uncertainties to explorations of how individuals' food environments relate to their food behaviors. This viewpoint discusses the need for, and implications of, considering household members when measuring food access and disentangling the behavioral pathways connecting the food environment to diet. Ultimately, a conceptual framework and potential questions are proposed to integrate household members into food environment research.

Low Cooking Skills Are Associated with Overweight and Obesity in Undergraduates

Culinary skills are defined as the confidence, attitude, and the application of one's individual knowledge in performing culinary tasks, and their development may be associated with better diet quality and better health status. This study aimed to analyze the association between cooking skills, overweight, and obesity in undergraduates. This is a descriptive, observational, and cross-sectional study, with data collected between October 2020 and March 2021, with undergraduate students (n = 823) at the Federal University of Rio Grande do Norte. Participants answered the online Brazilian Cooking Skills and Healthy Eating Questionnaire Evaluation, BCSQ, which included socioeconomic information. Logistic regressions were used to assess the associations of cooking skills with overweight and obesity. From the total of the students, 70.8% were female, with a median age of 23 (21-30) years; 43.6% were with overweight or obesity; 48.8% were eutrophic; and 7.7% underweight. Overweight and obesity were significantly associated with low levels of culinary self-efficacy and self-efficacy in the use of fruits, vegetables, and seasonings in the bivariate analysis. The logistic regressions showed that living with other people and eating out were associated with higher chances of overweight and obesity. Sharing the responsibility for preparing meals and a high self-efficacy in the use of fruits, vegetables, and seasonings were associated with lower chances for overweight/obesity. Overall, our study showed that overweight and obesity were associated with lower cooking skills in the studied undergraduates. Therefore, the study demonstrates that culinary skills can be explored in educational programs that aim to reduce overweight/obesity in students.

Effectiveness of a School-Based Culinary Programme on 9- and 10-Year-Old Children's Food Literacy and Vegetable, Fruit, and Breakfast Consumption

School-based culinary courses may increase children's food literacy and improve their eating behaviours. This study assessed the impact of a school-based culinary programme on 9- and 10-year-old students' food literacy and vegetable, fruit, and breakfast consumption. This cluster quasi-experimental trial compared 88 grade 4 and 5 students who participated in the Apprenti en Action programme to 82 students who did not. Students' food literacy and eating behaviours were assessed with a self-administered questionnaire. The programme's impact on vegetable and fruit consumption, cooking skills, food skills, and food knowledge was measured using MANOVA, and the odds of eating breakfast at least five times per week were assessed with logistic regression. Students who participated in the programme reported a greater increase in their cooking skills (p = 0.013) and food knowledge (p = 0.028) than students in the control group. No effect was found on food skills and vegetables, fruit, and breakfast consumption (p-values > 0.05). Boys improved their cooking skills (p = 0.025) and food knowledge (p = 0.022), but girls did not. The programme improved students' cooking skills and food knowledge, especially among boys; however, modifications are needed to improve students' food skills and eating behaviours.

Involvement of Brazilian adolescents in home cooking: An exploratory analysis (EVA-JF Study)

OBJECTIVE

The aim of this study was to investigate the involvement of Brazilian adolescents in home cooking, estimating its associations with sex and socioeconomic status.

METHODS

This cross-sectional study involved a probabilistic sample of 14- to 19-y-olds enrolled in 29 public schools in the municipality of Juiz de Fora, MG, Southeast Brazil (n = 835). To assess involvement in home cooking, a 12-question questionnaire was used. The content was based on the Brazilian Food Guide, which encourages the acquisition, development, and sharing of culinary skills. Pearson's χ test and Poisson regression models were carried out, without and with adjustments.

RESULTS

Most of the adolescents did not usually participate in meal planning (61%), and in the choice/purchase of food and culinary ingredients (67%). Boys were less likely to know how to cook "from scratch", positively self-evaluate their culinary skills, enjoy cooking, wish to learn more about cooking and meal preparation, and to participate frequently in the planning and preparation of meals. Belonging to a lower socioeconomic status represented a greater probability of preparing meals alone for the family.

CONCLUSIONS

We verified an alarming prevalence of adolescents with behaviors unaligned with Brazilian Food Guide recommendations; that is, most of them, especially boys, were not involved in home cooking. Adolescence may present a window of opportunity for the development of culinary skills, resulting in long-term benefits for the population's diet quality. Furthermore, to change a historical pattern that overloads women's daily lives, it is necessary to encourage, from an early age, the presence of boys in the kitchen.

Association of household air pollution with glucose homeostasis markers in Chinese rural women: Effect modification of socioeconomic status

BACKGROUND

Socioeconomic status (SES) was a crucial influencing factor of household air pollution (HAP). However, few studies have explored the potential effect modification of SES on the associations of HAP with type 2 diabetes mellitus (T2DM) and glucose homeostasis.

METHODS

A total of 20900 participants were obtained from the Henan Rural Cohort. HAP reflected by cooking fuel type and cooking duration was assessed via questionnaire. SES was evaluated by two dimensions: educational level and average monthly income. Associations of cooking fuel type, cooking duration with T2DM and glucose homeostasis indices (insulin, fasting plasma glucose (FPG), and HOMA-β) were assessed by the generalized linear model. Analyses were also conducted in different SES groups to explore the potential effect modification.

RESULTS

Significant negative association of cooking fuel type and cooking duration with T2DM, FPG, and HOMA-β was not observed. However, cooking with solid fuel and long-duration cooking were associated with decreased insulin level in women, and the adjusted coefficients were - 0.35 (95% confidence interval (95% CI): - 0.53, - 0.17) and - 0.36 (95% CI: -0.50, -0.21), respectively. Results from stratified analyses showed that these associations were more prominent in women with low average monthly income, with corresponding coefficient of - 0.57 (95% CI: -0.77, -0.37) for cooking with solid fuel and - 0.34 (95% CI: -0.52, -0.16) for long-duration cooking. Among women with low average monthly income, the largest decreased insulin level was observed in those who cooked with solid fuel, long-duration and poor kitchen ventilation, while the negative association of cooking fuel type and cooking duration with insulin level was slightly alleviated in the good kitchen ventilation group.

CONCLUSIONS

Low average monthly income aggravated the negative association of HAP and insulin level among rural women, while improving kitchen ventilation may be a practical intervention.

TRAIL REGISTRATION

The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. http://www.chictr.org.cn/showproj.aspx?proj=11375.

Use of a focus group-based cognitive interview methodology to validate a cooking behavior survey among African-American adults

Disparities in diet-related diseases persist among African-Americans despite advances in risk factor identification and evidence-based management strategies. Cooking is a dietary behavior linked to improved dietary quality and cardiometabolic health outcomes. However, epidemiologic studies suggest that African-American adults report a lower frequency of cooking at home when compared to other racial groups, despite reporting on average cooking time. To better understand cooking behavior among African-Americans and reported disparities in behavior, we sought to develop a survey instrument using focus group-based cognitive interviews, a pretesting method that provides insights into a survey respondent's interpretation and mental processing of survey questions. A comprised survey instrument was developed based on input from a community advisory board, a literature review, and a content review by cooking behavior experts. The cognitive interview pretesting of the instrument involved African-American adults (n = 11) at risk for cardiovascular disease who were recruited from a community-based participatory research study in Washington, D.C., to participate in a focus group-based cognitive interview. Cognitive interview methodologies included the verbal think-aloud protocol and the use of retrospective probes. Thematic analysis and evaluation of verbalized cognitive processes were conducted using verbatim transcripts. Five thematic themes related to the survey were generated: (1) Clarity and relevancy of question items; (2) influence of participants' perspectives and gender roles; (3) participant social desirability response to questions; (4) concern regarding question intent. Eleven survey items were determined as difficult by participants. Cooking topics for these items were: cooking practices, cooking skills, cooking perception (how one defines cooking), food shopping skills, and socialization around cooking. Question comprehension and interpreting response selections were the most common problems identified. Cognitive interviews are useful for cooking research as they can evaluate survey questions to determine if the meaning of the question as intended by the researcher is communicated to the respondents-specific implications from the results that apply to cooking research include revising questions on cooking practice and skills. Focus-group-based cognitive interviews may provide a feasible method to develop culturally grounded survey instruments to help understand disparities in behavior for culturally relevant diet behaviors such as cooking.

Cooking at home to retain nutritional quality and minimise nutrient losses: A focus on vegetables, potatoes and pulses

Cooking at home has experienced a decline in many countries since the mid-20th century. As rates of obesity have increased, there has been an emphasis on more frequent home cooking, including its incorporation into several food-based dietary guidelines around the world as a strategy to improve dietary quality. With the recent trend towards the adoption of diets richer in plant-based foods, many consumers cooking at home may now be cooking plant foods such as vegetables, potatoes and pulses more often. It is, therefore, timely to explore the impact that different home cooking methods have on the range of nutrients (e.g. vitamin C and folate) and bioactive phytochemicals (e.g. carotenoids and polyphenols) that such plant foods provide, and this paper will explore this and whether advice can be tailored to minimise such losses. The impact of cooking on nutritional quality can be both desirable and/or undesirable and can vary according to the cooking method and the nutrient or phytochemical of interest. Cooking methods that expose plant foods to high temperatures and/or water for long periods of time (e.g. boiling) may be the most detrimental to nutrient content, whereas other cooking methods such as steaming or microwaving may help to retain nutrients, particularly those that are water-soluble. Dishes that use cooking liquids may retain nutrients that would have been lost through leaching. It may be helpful to provide the public with more information about better methods to prepare and cook plant foods to minimise any nutrient losses. However, for some nutrients/phytochemicals the insufficient and inconsistent research findings make clear messages around the optimal cooking method difficult, and factors such as bioaccessibility rather than just quantity may also be important to consider.

Who's cooking tonight? A time-use study of coupled adults in Toronto, Canada

Understanding how coupled adults arrange food-related labor in relation to their daily time allocation is of great importance because different arrangements may have implications for diet-related health and gender equity. Studies from the time-use perspective argue that daily activities such as work, caregiving, and non-food-related housework can potentially compete for time with foodwork. However, studies in this regard are mostly centered on individual-level analyses. They fail to consider cohabiting partners' time spent on foodwork and non-food-related activities, a factor that could be helpful in explaining how coupled partners decide to allocate time to food activities. Using 108 daily time-use logs from seventeen opposite-gender couples living in Toronto, Canada, this paper examines how male and female partners' time spent on non-food-related activities impact the total amount of time spent on foodwork by coupled adults and the difference in time spent on foodwork between coupled women and men. Results show that both male and female partners took a higher portion of foodwork when their partner worked longer. When men worked for additional time, the couple-level duration of foodwork decreased. Without a significant impact on the gender difference in foodwork duration, women's increased caregiving duration was associated with a reduction of total time spent on foodwork by couples. An increase in caregiving and non-food-related chores by men was associated with an increased difference in duration of foodwork between women and men, which helped secure a constant total amount of foodwork at the couple level. These behavioral variations between men and women demonstrate the gender differences in one's responsiveness to the change of partners' non-food-related tasks. The associations found among non-food-related activities and foodwork are suggestive of a need to account for partners' time allocation when studying the time-use dynamics of foodwork and other daily activities.

An elective high school cooking course improves students' cooking and food skills: a quasi-experimental study

INTERVENTION

The Professional Cooking (PC) course is an optional 18-week experiential learning course offered in francophone high schools in New Brunswick, Canada. Students are taught how to measure ingredients, read and follow recipes, prepare and cook various foods using different culinary techniques, and apply food safety practices.

RESEARCH QUESTION

What is the effectiveness of the PC course on high school girls' and boys' cooking and food skills, vegetable and fruit consumption, and other eating behaviours?

METHODS

Students enrolled in the PC course (n = 124) or a mandatory Personal and Social Development (PSD) course (n = 202) in five high schools were recruited. Students' food and cooking skills, vegetable and fruit consumption, and other eating behaviours were collected through a self-administered, pre-post questionnaire. Group differences were assessed with mixed-effect regression models, and separate gender analyses were conducted.

RESULTS

Students in the PC course reported greater increases in food (β=5.74, 95% CI 1.65, 9.83) and cooking skills (β=10.33, 95% CI 5.59, 15.06) than students in the PSD course. Girls and boys in the PC course reported greater improvements in cooking skills (β=8.68, 95% CI 2.57, 14.80; β=11.97, 95% CI 4.39, 19.57, respectively) than those in the PSD course. No effect was found for vegetable and fruit consumption or other eating behaviours (all p values > 0.05).

CONCLUSION

The PC course effectively improved students' cooking skills. Curriculum-integrated high school cooking courses provide a foundation for healthier eating by helping students develop food literacy skills and should be mandatory in schools.

Current Sex Distribution of Cooking and Food Shopping Responsibilities in the United States: A Cross-Sectional Study

Home cooking is an important obesity prevention strategy and associated with benefits for diet and health. Although cooking may be a joyful act of mindfulness, it also requires planning, preparation and time. Historically, women have been more likely to fulfill the role of food shopping and cooking. More recent studies suggested a transition in traditional household role assignments towards a larger involvement of males. This study examined the current sex distribution of cooking and food shopping responsibilities in the United States of America based on a nationally representative sample of 9078 citizens from the National Health and Nutrition Examination Surveys (2017–2020). More than 80% of women aged 25 years or older indicated that they were the person who did most of the planning/preparing of meals in their families, whereas the percentage of males responding affirmatively was substantially lower, ranging from 38.73% to 43.20% depending on age. Analyses on food shopping duties revealed a comparable distribution. In multivariate regression, female sex was associated with significantly higher odds of being the main food shopper/meal preparer in the family (OR: 4.82 (4.14–5.60) and 5.54 (4.60–6.67), respectively). Our data suggest that the majority of food shopping and cooking duties are still performed by women, which has important implications for public health nutrition initiatives.

Food Away from Home Frequency, Diet Quality, and Health: Cross-Sectional Analysis of NHANES Data 2011-2018

The consumption of meals prepared away from home (FAFH) in the U.S. has been commonly linked to overall poorer diet quality; however, less is known about the relationship with health parameters. The aim of this cross-sectional study was to assess the diet quality and health parameters of adults who reported the frequency of obtaining or eating FAFH using a combination of four 2-year cycles of National Health and Nutrition Examination Survey (NHANES, 2011−2018) data. Data from 14,999 adults aged 20 to 65 years were used to examine the associations between diet and health outcomes and the weekly frequency of FAFH. Multivariable regression models were used to compare Healthy Eating Index-2015 (HEI-2015) scores by FAFH frequency, adjusting for sociodemographic variables. Adults with more frequent FAFH meals were more likely to be younger, male, lower-income, and unmarried. Total HEI-2015 scores and component scores for greens and beans, total and whole fruits, whole grains, saturated fats, and added sugars were significantly lower in those consuming >2 FAFH meals/week vs. ≤2 FAFH meals/week. BMI and waist circumference tended to be higher for women having more frequent FAFH meals. More frequent FAFH meals among adults were associated with poorer diet quality and weight outcomes, building on results from earlier studies.

Kitchen ventilation alleviated adverse associations of domestic fuel use and long-duration cooking with platelet indices as biomarkers of cardiovascular diseases

BACKGROUND

Abnormal platelet activity is considered as a potential mechanism of cardiovascular diseases (CVDs) related to household air pollution (HAP). However, evidence remains lacking for the association of HAP with platelet activity in low-middle income countries.

METHODS

27,349 individuals were obtained from the Henan Rural Cohort Study. A questionnaire was used to collect data on cooking fuel types, cooking frequency and time as well as kitchen ventilation which indirectly reflected HAP. Platelet activity was indicated by platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), ratio of mean platelet volume to platelet count (MPVP), platelet-large cell ratio (P-LCR) and plateletcrit (PCT). Associations of HAP with platelet activity were assessed by generalized linear mixed models.

RESULTS

Compared with the ones without cooking, participants who cooking using solid fuel, clean fuel, short- and long-duration cooking were at a high risk for increased platelet size (PDW, MPV, MPVP and P-LCR) but decreased PLT and PCT; long-duration cooking participants with non-using exhaust hood/extractor by solid fuel use were associated with a 0.259 f. (95%CI: 0.100, 0.418 fL), 0.115 f. (95%CI: 0.050, 0.181 fL), 0.001 (95%CI: 0.000, 0.003) and 0.928% (95%CI: 0.425, 1.431%) increment in PDW, MPV, MPVP and P-LCR values and these associations were prominent in women relative than that in men.

CONCLUSION

Using exhaust hood/extractor attenuated the positive associations of solid fuel use and long-duration cooking with increased platelet size in all participants and these associations were prominent in women, indicating that improving kitchen ventilation may be an effective strategy to reduce platelet dysfunction related to HAP, especially for women.

Consumer behavior during the COVID-19 pandemic: An analysis of food purchasing and management behaviors in U.S. households through the lens of food system resilience

The COVID-19 pandemic has stimulated considerable interest in the resilience of the U.S. food system. Less attention has been paid to the resiliency characteristics of the final link in the food system - individual households. We use national survey data from July 2020 to understand the food acquisition, preparation, and management strategies that households implemented in response to the pandemic. We find a substantial increase in the amount of food prepared and consumed at home which scales with respondents' time availability, perceived risks of dining out, and pandemic-induced income disruption. We then identify several household responses to support this increase in home food consumption that are in line with practices suggested to enhance resiliency at other links in the food supply chain, including increased cold storage capacity and enhanced in-house capability via improved cooking and food management skills. We discuss how responses such as improved food skills can reduce the propagation of shocks through the supply chain by allowing greater flexibility and less waste, while actions such as increased home cold storage capacity could undermine system resilience by exacerbating bullwhip effects, i.e., amplifying consumer demand shocks that are propagated to upstream food supply chain actors.

Food Insecurity and Depression among US Adults: NHANES 2005-2016

A growing body of evidence suggests that food insecurity is associated with adverse mental health outcomes such as depression and anxiety. In this study, the relationship between food insecurity and depression was examined using data from the 2005−2016 National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module with zero affirmative responses indicating high food security, 1 or 2 affirmative responses indicating marginal food security, and ≥3 affirmative responses indicating food insecurity. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. Data were analyzed from 28,448 adult participants aged 20 or older. Food insecurity was present in 19.2% of the sample population (n = 5452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Fully food secure and very low food security adults experienced depression at a rate of 5.1% and 25.8%, respectively (Rao-Scott chi-square, p < 0.0001). Participants with very low food security had a significantly greater odds of depression than food secure adults, OR = 3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factors for depression in US adults over 20 years of age. To address this issue in our citizenry, police initiatives and public health interventions addressing both food access and mental health should be prioritized.

Cultural Influences on Family Mealtime Routines in Mexico: Focus Group Study with Mexican Mothers

Mexico’s obesity rates are alarming, and experts project drastic increases in the next thirty years. There is growing interest in understanding how remote acculturation and globalization processes influence health behaviors. The present study used focus group data from a central state, San Luis Potosí, in Mexico to explore mothers’ perspectives on factors that influence family mealtime routines. Thematic analysis was used to identify barriers and facilitators to healthy mealtime routines and diet within families. Twenty-one mothers participated in the focus groups; 76% were full-time stay at home mothers, the majority were low-income (65%), and fewer than half reached a high school education. Three major themes emerged: (1) mothers do most of the visible work involving mealtime routines; (2) family meals are different today, and globalization is a contributing factor; and (3) family mealtimes are shifting to weekend events. Empowering mothers to negotiate diet with family members to build healthy routines, navigate challenges due to changing environments, and set family boundaries around technology use during mealtimes should be taken into consideration when promoting healthy behaviors with Mexican families.

Practical, Evidence-Based Approaches to Nutritional Modifications to Reduce Atherosclerotic Cardiovascular Disease: An American Society For Preventive Cardiology Clinical Practice Statement

Despite numerous advances in all areas of cardiovascular care, cardiovascular disease (CVD) is the leading cause of death in the United States (US). There is compelling evidence that interventions to improve diet are effective in cardiovascular disease prevention. This clinical practice statement emphasizes the importance of evidence-based dietary patterns in the prevention of atherosclerotic cardiovascular disease (ASCVD), and ASCVD risk factors, including hyperlipidemia, hypertension, diabetes, and obesity. A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein and fatty fish is optimal for the prevention of ASCVD. Consuming more of these foods, while reducing consumption of foods with saturated fat, dietary cholesterol, salt, refined grain, and ultra-processed food intake are the common components of a healthful dietary pattern. Dietary recommendations for special populations including pediatrics, older persons, and nutrition and social determinants of health for ASCVD prevention are discussed.

Food Media and Dietary Behavior in a Belgian Adult Sample: How Obtaining Information From Food Media Sources Associates With Dietary Behavior

Objective: We aim to relate Flemish adults’ main food information sources (e.g., celebrity chefs, experts) with their dietary behavior.

Methods: A cross-sectional online survey among 1115 Flemish adults who regularly cook, measured the food information sources the respondents used to obtain recipes, their dietary intake and dietary restrictions. Ordinal and logistic regression were used to investigate the relation between food media, dietary intake and dietary restrictions.

Results: Celebrity chefs were mentioned most often (37%) as main food information source, followed by family and acquaintances (21%) and lifestyle gurus (12%). Using lifestyle gurus as a source of dietary information is associated with more dietary restrictions and a higher intake frequency of plant-based food groups, whereas using celebrity chefs or experts is associated with a different (but less unequivocal vegetarian or healthy) dietary intake.

Conclusion: Media icons like lifestyle gurus and celebrity chefs appear to be among people’s main sources of food information. There is a significant association between using them as a source of food information and dietary behavior. Further research on the influence of media on diet is required.

Impacts of A Taste of African Heritage: A Culinary Heritage Cooking Course

OBJECTIVE

To examine changes in cooking and dietary behaviors and health outcomes following participation in A Taste of African Heritage, a culinary heritage cooking course.

DESIGN

One group, pre-post program design, surveys, and physical assessments.

SETTING

Community centers, churches, health care settings, homes, and housing complexes.

PARTICIPANTS

Participants (n = 586, 84% women) were recruited by partner organizations from 2013-2018 across 21 states and the District of Columbia.

INTERVENTION(S)

A 6-week cooking curriculum that teaches history, nutrition, and cooking techniques to reconnect participants with the vibrant, healthy traditions of the African Diaspora.

MAIN OUTCOME MEASURE(S)

Weekly frequency of cooking, food group intake, and exercise assessed by surveys, measured weight, waist circumference, and blood pressure.

ANALYSIS

Linear and logistic mixed-effects models with random intercepts for participant and teacher, sex and site type as covariates comparing pre-post physical measurements and binary behavioral outcomes, P < 0.0033 for statistical significance after Bonferroni correction.

RESULTS

Intake frequencies of fruit, vegetable, and greens and exercise frequency were improved from preprogram to postprogram (all P < 0.0021). Weight, waist circumference, and systolic blood pressure were also improved from preprogram to postprogram (all P <0.0001).

CONCLUSIONS AND IMPLICATIONS

Participation in A Taste of African Heritage was associated with positive behavior changes and health outcomes. Integrating cultural heritage and behaviors are positive components to connect participants to healthy old ways or traditions.

Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth

Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.

Examining foodwork and eating behaviors among heterosexual and gay male couples

OBJECTIVES

Spouses play an important role in their partner's eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors.

METHOD

Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b).

RESULTS

We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation.

CONCLUSION

Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts.

Tailoring nutrition and cancer education materials for breast cancer patients

OBJECTIVE

Many breast cancer patients are vulnerable to poor nutritional status and may benefit from nutrition education, but existing materials are not generally tailored to the needs of low-literacy immigrant and minority patients.

METHODS

With nutritionist guidance, we developed a nutrition presentation for breast cancer patients. English- (n = 29) and Spanish-speaking (n = 19) patients were recruited from 5 safety-net hospitals, an academic cancer center, and a Latina cancer support organization. Materials were tested using multiple rounds of cognitive interviewing (with an adapted USDA interview guide), followed by study team reviews and modifications, until saturation.

RESULTS

Seven rounds of interviews per language were needed. Approximately 25% of interviewees had less than a high school education. Changes included adapting to regional lexicons and resolving vague/confusing phrasing. Specific food examples needed cultural tailoring. Text color coding (red/bad, green/good) was requested. Labeled images enhanced participants' understanding of concepts. Spanish speakers expressed a desire to understand nutrition labeling, and this was emphasized in the Spanish slides.

CONCLUSION

Cognitive interviews were an important tool for creating a nutrition curriculum tailored to the needs of low-literacy, mostly immigrant patients.

PRACTICE IMPLICATIONS

Cultural and linguistic factors should be considered for nutritional education materials in diverse patient populations.

An Evaluation of a Virtual Food Safety Program for Low-Income Families: Applying the Theory of Planned Behavior

Low-income families are reported to have a limited knowledge of food safety and resources to follow food safety practices compared with the rest of the population. This paper evaluated a virtual food safety educational program targeting food handlers in low-income families. Trained native speakers of English and Spanish delivered course materials in both languages. A total of 60 individuals participated in the program, with 30 participants in each language group. Most were female, and most had fewer than three children. After the program, participants’ food safety knowledge and self-reported safe food practice behavior scores increased significantly from 5.32 to 7.43 (out of 8.00) and from 24.78 to 29.30 (out of 35.00), respectively. The theory of planned behavior (TPB) was used to understand individuals’ behavior change intention of food safety practices. All the TPB constructs’ scores, including attitudes toward the behavior, perceived behavioral control, subjective norms, and behavior change intentions, were improved significantly; however, only the subjective norms and perceived behavioral control were significantly correlated with the behavior change intentions. This virtual educational program improved low-income individuals’ food safety knowledge and changed their food safety attitudes and behaviors, giving a path to develop and evaluate more virtual food safety educational programs in the future.

Hunger, Obesity, Public Policies, and Food-Based Dietary Guidelines: A Reflection Considering the Socio-Environmental World Context

Nowadays, the world has been characterized by hunger, obesity, and food loss and waste (FLW). With the COVID-19 pandemic, the food issue became more intense, serious, and evident. Hunger demands urgent actions. Obesity levels have been raised and are removing health and quality of life from the population. Production planting practices and the food supply chain are not necessarily ecologically friendly. Sustainability issues greatly intensify social problems. As well as food loss (FL), food waste (FW), and sustainability concerns, obesity, and malnutrition are enhanced due to the lack of knowledge by the population. Processed food (PF), packaging, and additives, despite still needing improvement, are essential to food security control. Nowadays, hunger is not due to insufficient agricultural practices but rather to inequality and absence of adequate public policies. In the context of a certain abundance of food production and processing, the hunger scenario in contrast to FLW is an ethical, social, moral, and sustainable issue. In this context, a Food-Based Dietary Guideline (FBDG) can be an important public policy tool from the health, nutrition, environmental, and educational points of view. Despite the effort, the literature shows that FBDGs can be better used to fulfill healthiness and sustainability purposes. In this scenario, the elaboration/revision of the FBDG, adopting a clearer, simpler, and a better-suited communication strategy is essential. In this way, this article discusses the importance of the FBDG as a public policy tool, not only regarding health issues but also communication strategies, production sustainability, and humanitarian ones, which are crucial to FBDG's efficiency.

Related Factors for Impaired Fasting Glucose in Korean Adults: A Population Based Study

Background

Individuals with impaired fasting glucose (IFG) who have poor health behaviors are at a greater risk for various health outcomes. This study compared the health behaviors and health literacy between individuals with non-IFG and IFG; factors that were associated with IFG were identified by sex.

Methods

This study was an observational study with a cross-sectional design based on data from the Korea National Health and Nutrition Examination Survey (KNHANES) that used a stratified, multi-stage, cluster-sampling design to obtain a nationally representative sample. This study analyzed the KNHANES Health Examination Survey and Health Behavior Survey from 2016 to 2018 (N=9919). Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors and health literacy to identify the risk factors for IFG.

Results

The prevalence of IFG among the total was 29.0% (weighted n=2826, 95% CI 27.8–30.2). In the IFG group, 63.6% were male and 36.4% were female (X²=320.57, p<.001). In multiple logistic regression by sex, the factors associated with IFG in male were as follows: age (50s; OR=2.36, 95% CI 1.79–3.13), high BMI (OR=2.27, 95% CI 1.78–2.90), frequent drinking (OR=1.83, 95% CI 1.23–2.72), and using nutrition fact labels (OR=1.35, 95% CI 1.05–1.75). Low economic status (OR=4.18, 95% CI 1.57–11.15) and high BMI (OR=2.35, 95% CI 1.29–4.28) were the affecting factors in female. On the other hand, employment status, perceived stress, and job type were not related to IFG in both male and female.

Conclusions

Strategies should be targeted to improve health behaviors and health literacy for those in their 40s and 60s, male in shift work, those who frequently dine out, overweight male, female with low economic statuses, and frequent drinkers. Moreover, healthcare providers should understand the barriers to health behaviors and literacy to effectively deliver healthcare service.

Consumer risk perception and trusted sources of food safety information during the COVID-19 pandemic

Risk perceptions and trusted sources of information may have influenced consumer food handling practices during the COVID-19 pandemic. This study used a mixed-method qualitative-quantitative approach to assess consumer risk perception and trusted sources of food safety information during the pandemic. From April to August of 2020, five waves of online surveys (N = 3,584, with a minimum of 700 per month) were distributed to a U.S. consumer panel, which included only primary food preparers and grocery shoppers. The online focus groups recruited participants (N = 43) from the first wave of survey respondents and were conducted via Webex from May to July 2020. Topics covered in both studies focused on food safety risk perceptions and trusted sources of information during the pandemic. Trusted sources of information included government agencies, healthcare professionals, scientists, and social media. Throughout the longitudinal study, survey respondents and focus group participants perceived a higher risk of getting COVID-19 from people than from food. Survey respondents believed that handwashing could protect them more from COVID-19 than from foodborne illnesses. Many focus group participants practiced handwashing to prevent them from contracting COVID-19 from food items. Both survey respondents and focus group participants trusted the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and healthcare professionals for COVID-19 and food safety information. Focus group participants trusted these entities because they provide information that is "scientifically proven." Survey data for all five months reported social media to be the least-trusted source of both COVID-19 and food safety information. Focus group participants agreed that social media has "misinformation." The findings suggest that increased risk perception may have caused consumers to adopt good hand hygiene. However, consumers may not be connecting such practices to food safety. Food safety educators can use this time of heightened risk perception to connect COVID-19 and food safety practices. Trusted entities of information also need to be aware of their impact on consumer behavior and provide consumers with proper food safety information.

Diet quality during the COVID-19 pandemic: Effects of workplace support for families and work-to-family enrichment in dual-earner parents with adolescent children

Organizational support goes beyond the work domain, supporting workers' family role and thus generating resources that lead to work-to-family enrichment. Workers may invest these resources in improving their, and their family's, diet quality. However, data on the link between work resources, enrichment and diet quality during the COVID-19 pandemic is still emerging. The present study contributes to this literature by exploring the actor and partner effects between perceived workplace support for families, work-to-family enrichment, and diet quality in different-sex dual-earner parents with adolescent children; the potential mediating role of work-to-family enrichment between perceived workplace support for families and diet quality was also explored. A sample of 430 different-sex dual-earner parents and one of their adolescent children (mean age 13.0 years, 53.7% female) were recruited in Rancagua, Chile, during March and June 2020. Mothers and fathers responded to a measure of work-to-family enrichment, and a measure of Perceived Workplace Support for Families. The three family members answered the Adapted Healthy Eating Index. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modelling. Results showed that fathers' perceived workplace support for families positively and directly affected their own diet quality (actor effect) as well as the mothers' diet quality (partner effect), while indirectly positively affected the adolescents' diet quality via work-to-family enrichment (partner effect). Mothers' perceived workplace support for families enhanced their own work-to-family enrichment, which in turn improved their diet quality (actor effects). These results suggest that resources that both parents acquire through family-friendly workplace policies have positive effects on the three family members' diet quality by different mechanisms. Policymakers and organizations must aim to promote family-friendly workplace policies, particularly during ongoing crisis such as a pandemic.

Cross-sectional association of Toxoplasma gondii exposure with BMI and diet in US adults

Toxoplasmosis gondii exposure has been linked to increased impulsivity and risky behaviors, which has implications for eating behavior. Impulsivity and risk tolerance is known to be related with worse diets and a higher chance of obesity. There is little known, however, about the independent link between Toxoplasma gondii (T. gondii) exposure and diet-related outcomes. Using linear and quantile regression, we estimated the relationship between T. gondii exposure and BMI, total energy intake (kcal), and diet quality as measured by the Health Eating Index-2015 (HEI) among 9,853 adults from the 2009–2014 National Health and Nutrition Examination Survey. Previous studies have shown different behavioral responses to T. gondii infection among males and females, and socioeconomic factors are also likely to be important as both T. gondii and poor diet are more prevalent among U.S. populations in poverty. We therefore measured the associations between T. gondii and diet-related outcomes separately for men and women and for respondents in poverty. Among females <200% of the federal poverty level Toxoplasmosis gondii exposure was associated with a higher BMI by 2.0 units (95% CI [0.22, 3.83]) at median BMI and a lower HEI by 5.05 units (95% CI [-7.87, -2.24]) at the 25^th percentile of HEI. Stronger associations were found at higher levels of BMI and worse diet quality among females. No associations were found among males. Through a detailed investigation of mechanisms, we were able to rule out T. gondii exposure from cat ownership, differing amounts of meat, and drinking water source as potential confounding factors; environmental exposure to T. gondii as well as changes in human behavior due to parasitic infection remain primary mechanisms.

Toxoplasmosis gondii (T. gondii) is a parasite that infects over 10 percent of the US population. T. gondii infection can cause serious health problems for some people, but most infections remain undiagnosed and subclinical. When an individual is infected, T. gondii can chronically reside in muscle and central nervous system (including brain) tissue. Previous studies have found that individuals with prior exposure to T. gondii may engage in more risky and impulsive behaviors, and risk tolerance and impulsivity may be related with individual’s diet. Our study examines whether individuals with T. gondii exposure have higher body mass index (BMI) and worse diets. We further discuss and test for alternative explanations that prevent us from establishing a causal relationship between T. gondii and BMI/diet. Overall, our results show that T. gondii exposure is related with higher BMI and worse diets among lower-income females in the US. Our results uncover a novel correlate of BMI and diets, and suggest the importance of investigating the broader public health impacts of chronic T. gondii infection.

Foodwork in the United Kingdom from 1983 to 2014: A compositional data analysis of repeat cross-sectional time use surveys

BACKGROUND

While foodwork (tasks required to access food, including home food preparation) in the UK declined toward the end of the 20th century, it is not known whether this trend has continued into the 21st century. While evidence suggests many people feel they lack the time to cook, it is not known whether this is attributable to increasing demands on their time.

METHODS

Analysis of repeat cross-sectional data from three UK time use surveys: 1983, 2000 and 2014; participants aged 19+ (N = 14,810). We analysed changes in foodwork participation across survey years using linear regression, adding interaction terms to determine whether trends varied between different socio-demographic groups. We categorized time use over 24 h into eight parts, forming a composition: (1) personal care; (2) sleep; (3) eating; (4) physical activity; (5) leisure screen time; (6) work (paid and unpaid); (7) socialising and hobbies; and (8) foodwork. We examined whether the time-use composition varied across survey years, testing for interactions with socio-demographic characteristics.

RESULTS

Foodwork declined significantly between 1983 and 2014. However, a concurrent increase in time spent on work was not observed. Instead, time spent on sleep and screen time increased significantly. The decline in foodwork was significant among women but not among men.

CONCLUSION

While many people in the UK continue to allocate time to foodwork on a daily basis, foodwork has continued to decline into the 21st century, though there was no concurrent increase in time being allocated to work, suggesting external and non-discretionary demands on time have not increased. Practitioners seeking to address a lack of time as a barrier to foodwork may wish to accommodate a broad definition of what this could mean.

Efficacy of Removing Bacteria and Organic Dirt from Hands-A Study Based on Bioluminescence Measurements for Evaluation of Hand Hygiene When Cooking

The objective of this study was to evaluate the efficacy of dirt removal (bacteria and organic matter) of several hand-cleaning procedures. The results from the hand hygiene experiment indicated that washing hands with warm water and soap for 20 s is the most effective method investigated when hands are either dirty or greasy. Even if not proper washing, rinsing under running water for 5 s is a cleaning procedure that may significantly reduce the probability of cross-contamination, as it removes 90% of the hands’ dirt. Although less effective than water and soap, the usage of antibacterial wipes was significantly more effective than wet wipes, indicating that they are a better choice when water and soap are not available. The results of this study enable us to inform consumers about the effectiveness of hand-cleaning procedures applied in their homes when cooking. Moreover, it can make consumers understand why, during the COVID-19 pandemic, authorities recommended washing hands as a preventive measure of infection and using an anti-bacterial hand gel or wiping hands with an antimicrobial wipe if water and soap are not available.

Adolescent-Reported Latino Fathers' Food Parenting Practices and Family Meal Frequency Are Associated with Better Adolescent Dietary Intake

Most studies of food-related parenting practices, parental meal involvement, and adolescent dietary intake have focused on maternal influences; studies of paternal influences, particularly among marginalized groups, are lacking. This study examined lower-income, Latino fathers' food parenting practices and involvement in planning meals, buying/preparing foods, and family meal frequency, separately and in combination, to identify relationships with adolescent food intake. Baseline data were used from Latino adolescents (10-14 years, n = 191, 49% boys) participating with their fathers in a community-based overweight/obesity prevention intervention. Fathers reported sociodemographic characteristics. Adolescents reported frequency of fathers' food parenting practices, fathers' food/meal involvement, and family meals and participated in 24 h dietary recalls. The analysis included regression models using GLM (generalized linear mixed model) and PLM (post GLM processing) procedures. Most fathers were married, employed full-time, and had annual incomes below USD 50,000. Favorable fathers' food parenting practices were associated with adolescent intake of more fruit and vegetables and fewer sugar-sweetened beverages, sweets/salty snacks, and less fast food (p < 0.05 or p < 0.01). No independent effects of family meal frequency or fathers' food/meal involvement were observed on adolescent dietary outcomes. Additional analyses showed favorable food parenting practices in combination with frequent family meals were associated with adolescents having a higher intake of fruit (p = 0.011). Latino fathers can have an important positive influence on adolescent dietary intake.

A Qualitative Study of Motivators, Strategies, Barriers, and Learning Needs Related to Healthy Cooking during Pregnancy

Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, strategies, and barriers related to healthy cooking during pregnancy. Pregnant individuals’ preferences for a cooking education program were also explored. We conducted five focus groups with pregnant individuals (n = 20) in Southeast Michigan in 2019. Focus groups were audio-recorded and transcribed verbatim, then double coded by two members of the research team. Mean gestational age was 18.3 ± 9.6 weeks. Common motivators included feeding other children, avoiding pregnancy complications, promoting fetal growth, and avoiding foodborne illness. Challenges included pregnancy symptoms, navigating nutrition recommendations, mental energy of meal planning, family preferences, and time constraints. Strategies employed were meal planning and including a variety of foods. Participants identified organizational strategies, recipes, nutrition information, and peer support as important components of a cooking intervention during pregnancy. This study characterized multiple challenges to healthy home cooking during pregnancy, providing novel insight to inform the development of cooking skills education programs during this important life stage.

Mediterranean diet - promotion and dissemination of healthy eating: proceedings of an exploratory seminar at the Radcliffe institute for advanced study

The traditional Mediterranean diet is considered the world's most evidence-based eating pattern for promoting health and longevity. However, institutional food environments and their busy consumers often sacrifice health benefits for the convenience of faster and cheaper foods that generally are of lower quality and are more processed, and thus, contribute to the current epidemics of obesity and diabetes. Expert consensus has even identified the Mediterranean diet as the easiest to follow among healthy eating patterns. Nonetheless, fewer American families cook at home and many food services have been slow to implement healthier food options compatible with the Mediterranean diet. In September 2019, we convened a group of thought leaders at an exploratory seminar entitled: "Mediterranean Diet: Promotion and Dissemination of Healthy Eating", hosted by the Radcliffe Institute for Advanced Studies at Harvard University. The multidisciplinary faculty discussed best practices for translating traditional Mediterranean lifestyle principles to modern society.

Socioeconomic Inequalities in Food Consumption: A Cross-Sectional Study in Portuguese Adults

Background

Food is a major determinant of chronic noncommunicable diseases. Because of this, social inequalities in food consumption will likely produce social inequalities in disease and life expectancy.

Objectives

This study analyses the social inequalities in food consumption in Portugal and whether they differ between men and women and between younger and older people.

Methods

Following a cross-sectional observational study, we analyzed data from 11,085 individuals aged 25-64 years who participated in the 2014 National Health Interview Survey (NHIS). Logistic regression models were used to measure the association between socioeconomic conditions, i.e., education and income, and food consumption. The analysis was then stratified by sex and age.

Results

A positive gradient for income and education was observed in the consumption of fish, cakes, natural juices, and dairy products. The consumption of legumes and soft drinks was inversely related to income and education. A socioeconomic gradient for fruits and vegetables was observed only among women and older people. Worse-off people consumed less soup, and underprivileged women consumed fewer fast-food products.

Conclusion

The food consumption patterns of Portuguese adults are related to their socioeconomic condition, with few variations across demographic categories.